The acromioclavicular (AC) joint connects the collarbone (clavicle) to the highest point of the shoulder blade (acromion). This joint provides the only bony attachment of the arm to the rest of the skeleton. AC joint pain commonly results from a sudden traumatic injury, such as a fall directly onto the shoulder, or from degenerative changes like arthritis caused by repetitive stress, often seen in weightlifters. When the supporting ligaments are strained or torn, the resulting discomfort can significantly limit arm movement and daily activities. Managing this pain requires a structured approach, starting with immediate relief and progressing toward long-term joint stabilization.
Immediate Steps for Acute Pain
When AC joint pain first appears, the primary goal is to reduce inflammation and protect the joint from further stress. Immediately after an acute injury or severe flare-up, applying cold therapy minimizes swelling and numbs the painful area. Ice packs should be applied for 15 to 20 minutes, using a cloth barrier to prevent tissue damage, and repeated every few hours for the first 48 to 72 hours.
Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help manage pain and reduce inflammatory responses. These medications inhibit the body’s production of chemicals that promote inflammation. Temporary rest is also necessary; any activity that stresses the joint, particularly reaching overhead or carrying heavy objects, should be avoided. Limiting movement in the acute phase allows the initial healing process to begin.
Activity Modification and Joint Support
After the acute pain subsides, protecting the AC joint during daily function is important for proper healing. Temporary external supports, such as a simple arm sling, are often recommended for a short period to reduce tension on the joint. Slings are typically used for a few days to a week, but prolonged use is discouraged as it can lead to shoulder stiffness. Kinesiology or rigid athletic tape can also be applied over the AC joint to provide pain relief and stability by gently compressing the joint surfaces.
Modifying movement patterns is equally important, especially for activities involving pushing, pulling, or lifting. Movements requiring reaching across the body or lifting the arm above shoulder height often aggravate AC joint issues and should be limited. Weightlifting exercises like heavy bench presses, overhead presses, and dips must be avoided or modified to reduce direct strain. Additionally, avoid sleeping on the affected side, as direct pressure increases localized pain and disrupts healing.
Rehabilitation Exercises for Long-Term Stability
Once the acute pain phase has passed, the focus shifts to restoring function and building long-term stability through targeted rehabilitation exercises, ideally after consulting a physical therapist. The stability of the AC joint relies heavily on the surrounding shoulder and scapular muscles, including the rotator cuff. Strengthening these muscles helps control arm movement and reduces unnecessary strain on the joint.
Early-stage exercises involve gentle, pain-free range of motion work, such as pendulum exercises. The arm hangs down and is swung lightly in small circles, using gravity to promote blood flow and prevent stiffness without actively engaging the joint. As tolerance improves, the program advances to include isometric exercises (contracting muscles without joint movement) and light resistance band work focusing on scapular retraction. Scapular retractions strengthen the upper back muscles that stabilize the shoulder girdle. These exercises must be performed at a low intensity and stopped immediately if they cause increased pain.
Understanding Medical Intervention and When to Seek Help
While many AC joint issues improve with conservative measures, distinct signs warrant professional medical evaluation. Severe, unrelenting pain that does not improve after several days of rest and anti-inflammatory medication is a primary concern. Additionally, any noticeable deformity, such as a prominent bump on top of the shoulder, or an inability to move the arm suggests a more severe injury, requiring X-rays for accurate diagnosis.
If conservative treatments fail to provide lasting relief, a physician may suggest non-surgical medical interventions. Corticosteroid injections, often guided by ultrasound, can be delivered directly into the AC joint for powerful anti-inflammatory effects. These injections temporarily relieve pain, creating a window of opportunity for the patient to engage more fully in physical therapy and strengthening exercises. While effective for pain management, injections do not address the underlying structural issue, and their effects typically wear off after a few weeks to months.